Epilepsy related multimorbidity, polypharmacy and risks in adults with intellectual disabilities: a national study
dc.contributor.author | Sun, JJ | |
dc.contributor.author | Perera, B | |
dc.contributor.author | Henley, W | |
dc.contributor.author | Angus-Leppan, H | |
dc.contributor.author | Sawhney, I | |
dc.contributor.author | Watkins, L | |
dc.contributor.author | Purandare, KN | |
dc.contributor.author | Eyeoyibo, M | |
dc.contributor.author | Scheepers, M | |
dc.contributor.author | Lines, G | |
dc.contributor.author | Winterhalder, R | |
dc.contributor.author | Ashby, S | |
dc.contributor.author | De Silva, R | |
dc.contributor.author | Miller, J | |
dc.contributor.author | Philpott, DE | |
dc.contributor.author | Ashwin, C | |
dc.contributor.author | Howkins, J | |
dc.contributor.author | Slater, H | |
dc.contributor.author | Medhurst, D | |
dc.contributor.author | Shankar, Rohit | |
dc.date.accessioned | 2022-01-25T08:35:39Z | |
dc.date.available | 2022-01-25T08:35:39Z | |
dc.date.issued | 2022-05 | |
dc.identifier.issn | 0340-5354 | |
dc.identifier.issn | 1432-1459 | |
dc.identifier.uri | http://hdl.handle.net/10026.1/18614 | |
dc.description.abstract |
BACKGROUND: A quarter of people with Intellectual Disability (ID) in the UK have epilepsy compared to 0.6% in the general population and die much younger. Epilepsy is associated with two-fifths of all deaths with related polypharmacy and multi-morbidity. Epilepsy research on this population has been poor. This study describes real-world clinical and risk characteristics of a large cohort across England and Wales. METHODS: A retrospective multi-centre cohort study was conducted. Information on seizure characteristics, ID severity, relevant co-morbidities, psychotropic and antiseizure drugs (ASDs), SUDEP and other risk factors was collected across a year. RESULTS: Of 904 adults across 10 centres (male:female, 1.5:1), 320 (35%) had mild ID and 584 (65%) moderate-profound (M/P) ID. The mean age was 39.9 years (SD 15.0). Seizures were more frequent in M/P ID (p < 0.001). Over 50% had physical health co-morbidities, more in mild ID (p < 0.01). A third had psychiatric co-morbidity and a fifth had an underlying genetic disorder. Autism Spectrum Disorder was seen in over a third (37%). Participants were on median two ASDs and overall, five medications. Over quarter were on anti-psychotics. Over 90% had an epilepsy review in the past year but 25% did not have an epilepsy care plan, particularly those with mild ID (p < 0.001). Only 61% had a documented discussion of SUDEP, again less likely with mild ID or their care stakeholders (p < 0.001). CONCLUSIONS: Significant levels of multi-morbidity, polypharmacy and a lack of systemised approach to treatment and risk exist. Addressing these concerns is essential to reduce premature mortality. | |
dc.format.extent | 2750-2760 | |
dc.format.medium | Print-Electronic | |
dc.language | en | |
dc.language.iso | eng | |
dc.publisher | Springer Science and Business Media LLC | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 International | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.subject | Co-morbidity | |
dc.subject | Psychotropics | |
dc.subject | Mental health | |
dc.subject | Physical health | |
dc.subject | Neurodevelopment | |
dc.title | Epilepsy related multimorbidity, polypharmacy and risks in adults with intellectual disabilities: a national study | |
dc.type | journal-article | |
dc.type | Journal Article | |
dc.type | Multicenter Study | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000745750300001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.issue | 5 | |
plymouth.volume | 269 | |
plymouth.publication-status | Published | |
plymouth.journal | Journal of Neurology | |
dc.identifier.doi | 10.1007/s00415-021-10938-3 | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Health | |
plymouth.organisational-group | /Plymouth/Users by role | |
dc.publisher.place | Germany | |
dcterms.dateAccepted | 2021-12-11 | |
dc.rights.embargodate | 9999-12-31 | |
dc.identifier.eissn | 1432-1459 | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1007/s00415-021-10938-3 | |
rioxxterms.licenseref.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
rioxxterms.licenseref.startdate | 2022-01-24 | |
rioxxterms.type | Journal Article/Review |